Medical Dermatology by Toby Nelson

What is medical dermatology?

Medical dermatology is the diagnosis and treatment of diseases of the skin, hair and nails. There are over 2000 dermatological diseases. Some are common, affecting one in 10 people whereas others are extremely rare. Common conditions include eczema, psoriasis, acne, hair loss (alopecia), skin infections, vitiligo, rosacea, itch (pruritus) and excessive sweating.

What is a medical dermatologist? Many different grades of doctors work within the field of medical dermatology. Trainees, or registrars, must complete a robust four year programme and several exams before they can enter into the General Medical Council’s list of specialist dermatologists and at that point can apply for a consultant dermatology position.

Consultant dermatologists are also trained in either general medicine or paediatric medicine and therefore are also members of the Royal Colleges of Physicians (MRCP) or Paediatricians. It takes on average 10 years following medical school to become a consultant dermatologist. Other grades of doctors you may meet working within medical dermatology include staff grade, research fellows and associates.  These are often very experienced doctors but have not completed formal examination or been deemed competent by the GMC to work at consultant level.  There are only a few hundred medical dermatologists within the United Kingdom. There are many doctors claiming to be dermatology specialists as well as cosmetic dermatology clinics staffed by general practitioners and nurses who have only completed a short course in dermatology. These professionals are not the same as a consultant dermatologist.

You can check if your specialist has a medical licence and also if they are on the specialist register for dermatology on the General Medical Council. Only specialists can prescribe treatments that are most effective such as isotretinoin for acne or systemic therapies for eczema or psoriasis. Medical dermatologists often develop a specialist interest in a few areas. Dr Nelson has a broad knowledge of all medical dermatology with an interest in acne, eczema, alopecia and psoriasis. Rare disease of the skin often requires a referral to national centres of excellence. You can ask your GP to refer you to your local dermatologist in the first instance and if needed a second opinion can be sought.

Where can I find a medical dermatologist?

Most of your local specialists will have online profiles on your local hospital website. If you find a specialist who is no longer practising within the NHS then you should consider asking him or her why. All have been trained within the NHS and in Dr Nelson’s opinion should still remain part of it.